Healthcare Provider Details

I. General information

NPI: 1649128794
Provider Name (Legal Business Name): CELINA UNDERWOOD APRN PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/16/2026
Last Update Date: 03/16/2026
Certification Date: 03/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

220 45TH AVE
ST PETE BEACH FL
33706-2525
US

IV. Provider business mailing address

220 45TH AVE
ST PETE BEACH FL
33706-2525
US

V. Phone/Fax

Practice location:
  • Phone: 727-512-8183
  • Fax:
Mailing address:
  • Phone: 727-512-8183
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: CELINA UNDERWOOD
Title or Position: CEO
Credential: APRN, FNP
Phone: 727-512-8322